Objective: To test the effectiveness of psychological flexibility training on career adaptability among middle school students who undertook psychological courses based on acceptance commitment therapy and the adolescent mental flexibility model(DNA-V), and to provide a reference plan to improve the mental health of middle school students. Methods: This study recruited 110 junior high school students (60 boys and 50 girls) from a middle-school in Beijing. The students were randomly divided by class into a DNA-V face-to-face course group(offline group n=33), a DNA-V online course group(online group n=40), and a regular school psychology course group(control group n=37). Louise Hayes DNA-V intervention program was condensed into a six-hour middle-school DNA-V psychology curriculum. Using the Avoidance and Fusion Questionnaire for Youth and the Career Adaptability Scale, changes in psychological flexibility and career adaptability were measured before(T1), one week after(T2), and two months after (T3) the intervention. Results: Linear mixed models were used for the analysis, while controlling for demographic variables. Psychological flexibility and career adaptability in the offline group were higher at T2 and T3 than at T1(psychological flexibility t=4.22, 3.11; career adaptablity t=3.05, 4.16, P<0.01), while the difference between T2 and T3 was not statistically significant. The psychological flexibility and career adaptability of the online group were not statistically significant at T1, T2, and T3. The psychological flexibility and career adaptability of the control group increased from T1 to T2(t=4.64, 2.47, P<0.05), but T3 decreased back to a level close to T1. Conclusion In terms of both psychological flexibility and career adaptability, the DNA-V face-to-face psychology course resulted in a retention period of at least two months.

Objective To explore the relationship among psychological flexibility,coping style and job burnout of nurses.Methods A total of 694 nurses from one district level grade A tertiary general hospital in Yunnan were assessed using acceptance and action questionnaire 2nd edition (AAQ-Ⅱ),simplified coping style questionnaire (SCSQ) and nursing burnout scale (NBS).The relationship among psychological flexibility,coping style and job burnout of nurses was analyzed using structural equation model and Bootstrap test.Results (1) Correlation analysis showed that the total scores of AAQ-Ⅱ (21.81 ± 8.23),job burnout (22.71 ± 6.60) and its three dimensions including emotional exhaustion (8.93 ± 2.87),depersonalization (6.64±2.30)as well as reduced personal accomplishment(7.14±2.52) were positively correlated with negative coping dimension of coping style (10.86±4.99) (r=0.324-0.510,all P＜0.01),while negatively correlated with positive coping dimension(26.44±5.86) (r=-0.102--0.143,all P＜0.01).(2) Structural equation model analysis showed that positive and negative coping dimension had partial mediating effects on the relationship between psychological flexibility and job burnout (x2/df=2.30,GFI =0.91,AGFI =0.90,NFI=0.90,IFI=0.93,TLI=0.92,CFI=0.93,RMSEA=0.04).(3) Bootstrap test showed that the mediating effect sizes for positive and negative coping were 3.8％ and 8.9％ respectively and totally mediating effect size of coping style was 12.7％.Psychological flexibility had much larger effects on job burnout,and the direct effect size was 87.3％.Conclusion Coping style plays a mediating role in the relationship between psychological flexibility and job burnout,but its effect is less important.Psychological flexibility plays a major role and more directly influences on job burnout.

Objective:To revise the Chinese version of the Parental Psychological Flexibility Questionnaire (PPFQ) and test its validity and reliability.Methods:Totally 1015 parents from 2 primary school of Beijing were recruited and asked to complete the Chinese version of PPFQ.Item analysis was conducted to identify valid items.The parents were randomly allocated into two groups where one subset (n =510) was used for exploratory factor analysis (EFA),and the other (n =505) for confirmatory factor analysis (CFA) and discriminant validity.In addition,responses of 389 participants selected by simple random sampling was assessed in criterion validity with the Cognitive Fusion Questionnaire (CFQ),Acceptance and Action Questionnaire-Second Edition (AAQ-Ⅱ]),Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale (SDS),Mindful Attention Awareness Scale (MAAS),Trait Coping Style Questionnaire(TCSQ) and Conners Child Behavior Rating Scale (CBRS).Seven weeks later,225 of the participants were retested.Results:The exploratory factor analysis extracted 3 components,and explained 58.1％ of the total variance.The factor loading of items ranged between 0.63 and 0.86.The confirmatory factor analysis verified the 3-factors model (x2/df=1.77,NFI =0.94,IFI =0.97,GFI =0.96,TLI =0.96,CFI =0.97,RMSEA =0.04).Discriminant validity testing demonstrated the three revised factors had adequate discriminant validity in relation to one another (Ps ＜ 0.01).Criterion validity results showed that the total and subscale scores of the PPFQ were negatively correlated with the scores of CFQ,AAQ-Ⅱ,SAS,SDS,TCSQ-NC,CBRS (r =-0.16--0.52,Ps ＜ 0.01),and were positively correlated with the scores of MAAS,TCSQ-PC (r =0.14-0.37,Ps ＜ 0.01).The total and subscale scores of the PPFQ demonstrated good internal consistency Cronbach's α were 0.77-0.86 and test-retest reliability coefficient were 0.55-0.75.Conclusion:It suggests tthe validity and reliability of the adapted Chinese version of the Parental Psychological Flexibility Questionnaire be satisfactory,and could be used in the clinical and research work in China.

Objective To measure the reliability and validity of the Chinese version of the compre-hensive assessment of ACT processes(CompACT)in financial staffs. Methods A total of 3 735 valid ques-tionnaires were obtained from financial staffs.The valid questionnaires were randomly allocated into two groups,of which one subset(n=1 873)was used for exploratory factor analysis(EPA),and the other(n=1 845)for confirmatory factor analysis(CFA).Criterion and convergent validity were tested by Pearson corre-lation respectively.Incremental validity was tested by hierarchical regression analysis. Results The EFA suggested theoretically-coherent three-factor structure for a 15-itemed version of the CompACT.The three fac-tors named as acceptance and cognitive defusion,mindfulness and self as context,value and committed ac-tion,and explained 73.75% of the total variance and factor loadings ranged from 0.67 to 0.90.The CFA con-firmed the hypothesized three-factor mode(χ2/df=5.91,CFI=0.98,TLI=0.98,RMSEA=0.05). Conclu-sion The research suggests that the Chinese version of the CompACT has acceptable psychometric in prop-erties,so it can be applied in the assessment of the psychological flexibility and mental health in China.

Objective To compare the effects of Acceptance Commitment Therapy(ACT) and Cognitive Behavior Therapy(CBT) on anxiety and depression in the elderly,and to explore the psychological mechanism of ACT to improve anxiety and depression.Methods A total of 25 elderly people were screened from four communities in Beijing.According to the place of residence,12 persons were enrolled in the ACT group and 13 persons were enrolled in the CBT group.The mindful attention awareness scale,geriatric anxiety inventory,geriatric depression scale,the acceptance and action questionnaire-Ⅱ and cognitive fusion questionnaire were evaluated before regrouping (T1),after six regiments (T2) and 5 weeks after the end of the intervention (T3).Results (1) On the level of mindfulness,the score of ACT group was higher than that in CBT group at T2(ACT:80.31 ±6.18,CBT:74.20±4.48,t=2.52,P＜0.05) and T3 (ACT:82.20±4.48,CBT:70.00± 12.23,t=4.56,P＜0.01).(2) On the level of anxiety there was significant difference between the two groups at T2(ACT:2.88±1.86,CBT:8.87±2.80,t=-8.15,P＜0.01) and T3(ACT:5.38±2.02,CBT:10.50±2.66,t=-6.93,P＜0.01),and ACT group was higher than the CBT group.(3)On the levels of depression there was significant difference between the two groups at T 1 (ACT:4.59 ± 3.97,CBT:7.89± 6.39,t =-2.25,P＜0.05),the ACT group was lower than the CBT group.The CBT group on the levels of depression there was a significant difference T1 and T2 (t=2.92,P＜0.05).(4) On the level of psychological flexibility,there was a significant difference between the two groups at T2 (ACT:41.38 ± 8.28,CBT:49.60± 3.52,t =-3.64,P＜0.01)and T3(ACT:40.80±7.66,CBT:52.47±6.23,t=-4.98,P＜0.01),and ACT group was lower than the CBT group.(5) Empirical avoidance only achieved a significant level of intermediate effects between ACT therapy and anxiety.In the ACT group,the median effect of empirical avoidance on anxiety was 11.40％.Conclusion The effect of CBT on depression is better than that of ACT,while the effect of ACT on the level of mindfulness,anxiety and mental flexibility is better than that of CBT.ACT with psychological flexibility as a psychological mechanism can improve the mental flexibility of the individual more than the CBT.

Objective To explore the mechanism of parents' psychological flexibility and marriage quality on children's behavioral problems and to provide theoretical basis for the use of the acceptance and commitment therapy(ACT) to intervene children's behavioral problems.Methods Acceptance and action questionnaire-second edition(AAQ-Ⅱ),the cognitive fusion questionnaire (CFQ),the child behavior rating scale (CBRS),evaluating & nurturing relationship issues,communication,happiness (ENRICH) were used to investigate the parents of 310 pupils.Results (1) There were significant differences between father and mother in the total score of marriage(father(120.59±18.25) vs mother(129.65±21.61),P＜0.01),the score of children and marriage (father (29.80± 5.80) vs mother (33.26 ± 6.14)),the score of communication between husband and wife (father(28.75±6.48) vs mother(31.56±7.23)),and the score of experiential avoidance(father(21.48±9.85) vs mother(18.48±9.40)) and cognitive fusion scale (father (32.20± 12.46) vs mother(27.23± 13.70)) (P＜0.05).(2)The experiential avoidance of parents,the cognitive fusion of parents,the total score of marriage and subscales were significantly related to children's behavior problems (r=-0.35-0.81,P＜0.05 or 0.01).(3) The quality of marriage played a part intermediary role in the relationship between the two aspects of parents'psychological flexibility (experiential avoidance and cognitive fusion) and children behavior problems.The mediating effect was 32％ and 22.58％ respectively.Conclusion The psychological flexibility of parents can not only directly affect the behavior problems of children,but also affect the behavior problems of children through the quality of marriage as an intermediary variable.It can provide a new theoretical basis and effective methods to intervene and correct children behaviors problems.

Objective To assess the efficacy and significance of hepatic protection by observing the incidence of liver injury in patients with chemotherapy who were treated and untreated with traditional Chinese medicine (TCM).Methods A retrospective analysis was applied to compare the changes in liver function tests and incidence rate of drug -induced liver injury between the observation group (treated with TCM)and the control group (untreated with TCM)after chemotherapy.Results The incidence rates of liver injury in the observation group and control group was 4.7%(2 /43)and 23.9%(11 /46)respectively.The difference between the two groups was statisti-cally significant(χ2 =6.611,P =0.01).The ALT,AST,TBIL,ALP between the two groups had statistically signifi-cant differences after treatment (all P <0.05).Conclusion Using TCMin hepatic protection can improve liver tests and reduce the incidence of drug -induced liver injury from chemotherapy.

Objective To explore the mediating effect of psychological flexibility in the relationship between the two dimensions of type-D personality(negative affect and social inhibition)and pathological in-ternet use.Methods 592 university students were sampled from central China district and were adminis-tered with Adolescent Pathological Internet Use Scale(APIUS),Type-D personality scale(DS14)and Ac-ceptance and Action Questionnaire-Second Edition(AAQ-Ⅱ).Results Pathological internet use(2.56 ± 0.61)positively correlated with negative affect(1.58±0.78)and social inhibition(1.96±0.61)(r=0.37, 0.25)respectively,and negatively correlated with psychological flexibility(4.69±1.15)(r=-0.40).Path a-nalysis with latent variables showed psychological flexibility partially but significantly mediated the predictive effect of negative affect and social inhibition on pathological internet use.The mediation rates were 56% for negative affect and 62% for social inhibition.Conclusion Psychological flexibility has significant incremen-tal validity beyond two dimensions of type-D personality,and partially mediated the effect of negative affect and social inhibition on pathological internet use.These results suggest the intervention focus of PIU can be psychological flexibility.

Objective To investigate associate chief physician the clinical effects of Jiawei Jinhuang powder with fumigation -washing on hand -foot skin reaction(HFSR)caused by sorafenib.Methods 48 patients who received sorafenib were randomly divided into two groups.24 patients in the treatment group were administered Jiawei Jinhuang powder with fumigation -washing,and another 24 patients in the control group were given VitB6 orally.After 8 weeks,the incidence and grade of HFSR were statistically studied between the two groups.Results There was significant differences of hand -foot reaction between the treatment group and the control group (incidence rate:29.17% vs 70.83%,χ2 =8.375,P <0.05;The incidence rate of Ⅱ -Ⅲ:12.50% vs 33.33%,P <0.05 ). Conclusion Jiawei Jinhuang powder with fumigation -washing could remarkably reduce the incidence rate of HFSR caused by sorafenib.

Objective To explore the relationship between cognitive fusion and the state of anxiety and depression of perinatal women and to provide empirical evidences for acceptance and commitment therapy in mental treatment of anxiety and depression in perinatal women.Methods 309 perinatal women collected by cluster random sampling were assessed with self-made general information questionnaire,Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale (SDS) and Cognitive Fusion Questionnaire (CFQ) in predelivcry period and 3-7 days after childbirth respectively.Results (1) CFQ scores in the predelivery or postpartum anxiety group ((32.18±10.78),(31.54±10.30))were higher than that in the normal group((21.49±9.56),(20.84±9.82)),and the difference was statistically significant (t=-8.26,-8.22;all P=0.000);CFQ scores in the predelivery or postpartum depression group ((26.74 ±11.76),(26.84 ± 12.11)) were higher than that in the normal group((23.06± 10.33),(21.79±9.90)),and the difference was statistically significant(t=-2.76,-3.71;P=0.006,0.000).(2)It was found that the predelivery or postpartum CFQ scores were positively associated with the SAS scores of predelivery periods and postpartum periods respectively(r=0.51,0.45,0.50,0.55;P=0.000);the predelivery or postpartum CFQ scores were positively associated with the SDS scores of predelive1y periods and postpartum periods respectively (r =0.26,0.31,0.21,0.38;P =0.000).(3) Hierarchical multiple regression analyses were then conducted.The predelivery CFQ had a significant effect on postpartum SAS(△R 2=0.02,P=0.006)and postpartum SDS respectively(△R 2=0.02,P=0.006),and the regression equations were statistically significant.Conclusion A function to predict the occurrence of matemal postpartum anxiety and depression is obtained from the cognitive fusion which is attributed to the risk of maternal postpartum anxiety and depression.